Unknown rheumatic cardiac disease as cause of acute onset post-partum dyspnea: a case report

Unknown rheumatic cardiac disease as cause of acute onset post-partum dyspnea: a case report

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Abstract Background Acute post-partum dyspnea configures an obstetric challenge with multiple differential diagnosis.Case presentation We present a case of MIMULUS a previous healthy woman with preeclampsia who developed severe dyspnea 30 h after delivery.She complained of cough, orthopnea, and bilateral lower extremities oedema.She denied headaches, blurry vision, nausea, vomiting, fever or chills.Auscultation revealed a diastolic murmur, and was compatible with pulmonary oedema.

A timely bedside echocardiogram showed moderate dilated left atrium with severe mitral insufficiency suggestive of an unknown rheumatic disease.She was managed with noninvasive ventilation, loop diuretics, vasodilators, thromboprophylaxis, head-end elevation, and fluid restriction with progressive improving.Conclusions Hemodynamic changes in pregnant patients with previously silent cardiac disease may pose a challenge and cause post-partum dyspnea.This scenario requires a Laundry Wash Bag timely and multidisciplinary approach.